The present invention relates to a mouthmember as a mouthguard for the prevention of oro-maxillo-facial traumas deriving in particular from sporting activities and to an anatomical intra-oral mouth-piece incorporating the mouthguard.
Sport activity, normally a source of physical and psychic well-being, may occasionally cause a series of traumas to the athlete which, if not adequately prevented, may force him or her to long and costly rehabilitative therapies resulting in his/her temporary, or in the worst cases permanent, discontinuation of the sporting activity.
Oro-maxillo-facial traumas to which the present invention particularly relates, are associated to numerous sports. Some of them entail physical contact, such as boxing, rugby, football, martial arts; others, such as handball, basketball, skiing, tennis, cycling, though they do not entail physical contact, are nonetheless interested in the prevention of such traumas, as is unfortunately confirmed by the most up-to-date injury statistics.
The clinical documentation available in the literature confirms that very many athletes pay a high tribute to their sport in terms of injuries deriving from mandibular fractures, fractures of tooth crowns and roots, pulpal lesions and tooth avulsion or dislocation.
To the physical injury is also connected a large economic damage, correlated to the cost of the therapeutic and rehabilitative services, whose costs are very frequently borne by the community, where health legislation specifically provides for it.
In order to prevent traumas to the dental apparatus, dentistry specialists and sporting goods manufacturers supply endo-oral devices made of rubber-like materials, internationally known as "mouthguards".
The requirements a mouthguard has to meet in order to perform its protective function are many and generally known from the specialist literature of the sector.
Some such requirements are to isolate lips from teeth, to protect the upper teeth against direct hits, to mitigate or eliminate biting contacts, to keep maxillaries close together and to be adequately resilient. Additionally, the mouthguard has to allow the athlete to breathe through the mouth with maxilliaries shut, easily to swallow saliva and to speak in team sports. Lastly, protection has to be stable and retentive, and it has to integrate in the stomatologic system with no iatrogenic effect.
Ttwo categories of mouthguards are currently known: a first category is represented by mouthguards manufactured according to the user's personal morphology; the second category is instead represented by generically shaped mouthguards, manufactured in series with industrial methodologies and marketed in sporting goods shops.
Individual mouthguards are pressed on the printed of the individual's upper and lower dental arches and perfectly cover the dental crowns and the gum. Since they are modelled in a way that is wholly similar to a dental prosthesis, their design strictly corresponds to the athlete's anatomy, their size is calibrated and they guarantee an excellent protective function, a high in-situ stability and good comfort during their use.
Their usage, however, is extremely limited, due to the fact that the athlete needs the work of prosthetic specialists, has to undergo a rather long procedure for the preparation of the mouthguard and has to face a large expense.
A first type of series-produced (and therefore low price) mouthguard is represented by a ready to use product which is usually marketed in three standard sizes and which the athlete can wear immediately after purchasing it. This mouthguard has a generic and unchanging shape and adapts only coarsely to the athlete's specific anatomy: thus in most cases it is found to be unstable and awkward, it requires to be kept in place by constant biting and it interferes with speaking and breathing. Since this product is not retentive, its protective function is very limited and, whenever biting problems also exist, the medical/dental literature strongly recommends against their use.
A second type of industrially produced mouthguard, which is currently the most widely used because it is more comfortable than the previous one, though still inexpensive, is represented by a type made of thermoplastic material which can be immersed in boiling water and shaped by the athlete in his/her mouth using his/her fingers, tongue and biting pressure. Available in standard packages of a few different sizes, these mouthguards often lack an adequate extension and thickness. The marked reduction in occlusal thickness (70 to 99% of the initial thickness) that occurs during the adaptation phase, i.e. when the athlete bites the mouthguard uncontrolledly, entails a noticeable reduction in protective capacity, which is revealed in a particularly severe way in case of a hit to the chin. Under such conditions, the insufficient size of the space located between the athlete's upper and lower dental arches can be responsible for cranial and cerebral pressures with highly dangerous consequences.
Therefore, although this mouthguard is advantageous from the point of view of cost and is widely available on the market, it nonetheless affords insufficient protection against one of the most dangerous and severe traumas.
Wholly similar problems to the ones exposed above are found within the field of intra-oral anatomical mouth-pieces, of the kind which can be personalised, currently employed in breathing apparatuses for underwater sports.
The aforesaid mouth-pieces, as is well known, are made of rubber-like material and comprise an air (or oxygen) manifold, a retention element and two support inserts.
The manifold is the part that firmly connects the retention element to the breathing apparatus. The retention element is placed between lips and teeth and it has a hole to allow air passage. The support inserts extend intra-orally interposing themselves between the dental arches, so as to provide the diver with a gripping area which he/she can bite on, thus holding the mouthpiece stably in position.
Currently produced mouthpieces are also divided in two categories: a standard, ready to use type, and a type which can be personalised (with hot water) by virtue of the material it is made of. As for mouthguards, their shape does not correspond to the anatomy of the oro-dental apparatus. In particular, it can be noted that the design of the retention element profile, which does not take into account the backward position of the mandible with respect to the maxilla, forces the user to a slight protrusion of the mandibular position taking it to an aphysiological position which, coupled with the shape and size of the support areas, not calibrated according to the individual's anatomic design, force the athlete continually to shut his/her teeth together to hold the mouth-piece in place. These continual movements cause the retention element to rub against the gum with friction, resulting in injuries to the oro-dental apparatus.
Numerous pathological situations may arise as a consequence of the prolonged use of these types of mouth-pieces. Among them, the following have been observed: dysfunctions of the temporo-mandibular articulation with articular and muscular repercussions (pains) caused by a poor distribution of the occlusal load on the dental elements, which also aggravates any parodontal lesions which may be present; gingivitis caused by the continual rubbing of the retention element on the gums, due to the instability of the device. Moreover, the mouth-piece also hampers deglutition and therefore the opening of the Eustachian tubes, necessary for middle ear balance, causing the feeling that one's ears are occluded, and occasionally even leading to disorientation and vertigo.